1. Field of the Invention
This invention relates generally to an apparatus and method for use in surgical procedures and, more particularly, to an apparatus and method for stabilization of a cranial shunt or catheter.
2. Discussion of the Related Art
Shunts and/or catheters are used in the treatment of increased intracranial pressure, known as hydrocephalus, which can result from infection, injury or brain tumors. The increase in intracranial pressure generally occurs because there is an increase in the accumulation of cerebrospinal fluid within the ventricles of the brain. To relieve the intracranial pressure, it is sometimes necessary to insert a shunt or catheter into a burr hole formed into the skull. This enables the accumulated cerebrospinal fluid to flow out of or be removed from the skull, thereby reducing the intracranial pressure.
Various methods and techniques for stabilizing or fixedly securing the cranial shunt or catheter are known and used in the art. However, use of these various methods and techniques sometimes exhibit several disadvantages.
For example, one method of stabilizing a cranial shunt or catheter is to suture the cranial shunt directly to the skull or to the skin positioned proximate to the burr hole where the shunt is inserted. Alternatively, the portion of the shunt which exits the skull may simply be left alone or stabilized by taping this portion atop the skull. However, the disadvantage with these types of techniques is that the shunt could inadvertently be moved about or be removed from the skull, such as when a patient is moved.
Another stabilizing technique utilizes a cranial burr hole plate having a fixed diameter center hole. This fixed diameter center hole is used to hold a cap which is coupled to the cranial shunt, sometimes known in the art as a silastic cap. The silastic cap in combination with the burr hole plate stabilizes the shunt in a fixed relationship relative to the skull by securing the plate to the skull proximate the burr hole. This technique, however, also exhibits several disadvantages. For instance, because the plate utilizes a fixed diameter center hole, the plate may be used with only a single silastic cap having a size operable to fit within the center hole. Therefore, such a plate will not work with other silastic caps of differing shapes and sizes. This also eliminates the option of using silastic caps produced by various manufacturers because each manufacturer generally uses different shapes and sizes for its particular silastic cap. As a result, should a different size shunt or catheter be required, a unique and different plate would be required for each size shunt or catheter. Furthermore, use of such a plate would also increase surgical costs because multiple plates would have to be stored in a sterile condition and retrievable during the surgical procedure depending on the shunt size required. In addition, because this plate utilizes a fixed center hole, the silastic cap and the shunt must first be secured to the plate prior to insertion of the shunt. Therefore, the option of first inserting the shunt and later using the plate to stabilize the shunt without having to again remove the shunt is eliminated.
Another technique utilizes a generally rectangular shaped plate which is secured relative to the shunt such that the plate traps the shunt against the edge of the burr hole while the plate is secured to the skull. Wire may also be secured about the shunt and fixed to the plate to prevent the shunt from being removed from the burr hole. Here again, this technique has several disadvantages such as potentially creating an abrasion or kinking of the shunt relative to the edge of the burr hole.
What is needed then is an apparatus and method for stabilizing a cranial shunt or catheter which does not suffer from the above-mentioned disadvantages. This will, in turn, reduce the time and cost for such surgical procedures; enable various sizes and shapes of shunts or catheters to be utilized with a single apparatus adapted to be used with all shunt sizes; reduce the potential inadvertent removal of the shunt or catheter; eliminate the need for storing several size plates in order to use various shapes and sizes of shunts or catheters; and provide the option of attaching the apparatus to the shunt before or after the shunt is inserted into the burr hole without having to remove the shunt. It is, therefore, an object of the present invention to provide such an apparatus and method for stabilizing a cranial shunt or catheter.